Embodiment Therapy

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Trauma and the body

Ideas about trauma have changed significantly in recent years. Trauma is now understood less in terms of difficult memories and more in terms of its ongoing effects on the brain and body; the impacts of trauma are present in a person’s neurological and biological functioning. Unfortunately, many more people suffer from the effects of trauma than previously thought. At the same time, understanding trauma as deeply held in the body also opens up many more tools for healing.

If a person feels safe enough, paying deliberate attention to the body can allow difficult or uncomfortable patterns of feeling and sensation to emerge and resolve. Learning to listen to the body and to feel aliveness, enjoyment and resilience in the present can provide important and relieving signals to the brain and body that the trauma is over, so the person can move on. Renowned trauma expert Bessel van der Kolk explains:

“We have discovered that helping victims of trauma find the words to describe what has happened to them is profoundly meaningful, but usually it is not enough… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.”

From PTSD to complex trauma

Trauma was traditionally understood in fairly narrow terms. It was defined as the response to a terrible event, such as a life-threatening accident, natural disaster or assault, in which a person became overwhelmed and then unable to fully recover. According to this definition, trauma led to a series of clear and identifiable symptoms, such as distressing dreams, intrusive thoughts, flashbacks and avoiding reminders of the event.

Much of this understanding of trauma developed from the 1970s onwards, particularly in relation to war veterans returning from Vietnam. Many veterans found themselves unable to fully return to and participate in their own lives, long after their horrific experiences were over. This early definition of trauma, commonly known as post-traumatic stress disorder (PTSD), was mainly developed by psychoanalysts and psychiatrists working with veterans to establish better diagnoses and improve treatments.

More recently, trauma has been defined in broader terms, often using the term complex trauma. Researchers and psychiatrists noticed that some people who had experienced painful, ongoing situations in their lives, such as an abusive relationship or childhood neglect, showed similar signs of trauma as people with the more definable PTSD. They discovered that trauma may not always be traceable to a single event and that many people experience some but not all of the list of symptoms.

In fact, most people with a history of trauma do not meet the diagnostic criteria for trauma-related stress disorders yet they may experience the serious and ongoing repercussions of their past experiences, making it difficult to function in everyday life. These repercussions are often very much body-based, from intense and confusing emotional reactions, to physical symptoms such as the racing heart of anxiety or the deep fatigue of despair, to feeling profoundly disconnected from other people. Put simply, traumatised people often experience either feeling too much or feeling too little.

A new understanding of the nervous system

Contemporary discussions about trauma often make use of new ways of understanding how the nervous system functions. One particular neuroscientist, Stephen Porges, has pioneered new ways to think about the cascade of responses that occurs when people feel unsafe or threatened. Many people are already familiar with the terms fight-or-flight and freeze, as our systemic responses to threat. These responses are mediated by the autonomic nervous system, divided into two branches, the sympathetic and parasympathetic. But Porges added an important third branch—the social engagement system—mediated by the functioning of the vagus nerve. Not only does this system underpin our ability to connect with others, it is responsible for our first and most protective response to any threatening situation—to seek the reassurance and assistance of other people.


Whether or not someone develops trauma following a frightening or life threatening situation seems to depend at least partly on their perception of safety at the time. It depends greatly on whether someone feels safe by being supported and assisted by others, and whether the person has been able to act in a useful way at the time, such as running away to escape the situation. Peter Levine, a psychotherapist who developed new methods of working with the body and trauma, recounts his own experience of being hit by a car as a pedestrian. As he lay motionless on the road, a woman stepped forward from the crowd of onlookers and Levine was able to ask her to simply hold his hand. The calm, kind presence of another person, signalled through touch and eye contact, provided the crucial sense of safety that would make the event much less likely to result in the ongoing symptoms of trauma.

Porges’ view of the social engagement system also helps to explain the importance of safe relationships, particularly in early life when many situations may feel unfamiliar and unsafe to babies and small children. Without the feeling of safety, reassurance and support our nervous systems can become much more calibrated towards fight-or-flight or freeze, which can be the beginning of either feeling too much or feeling too little. In cases where children are neglected or abused the whole body and mind can develop this way, functioning as though a person is constantly under threat, eventually even in situations that are actually safe. Over time, functioning in this way extends well beyond the nervous system. The link between childhood trauma and chronic conditions (such as immune disorders, digestive problems and sleep disorders) is now well established. People who suffer from trauma often have numerous other physical complaints to deal with.

But what does it mean that the body holds trauma?

Even if we have some knowledge of the nervous system, it can be difficult to understand how exactly the body holds trauma. Better knowledge of the nervous system can help us to understand some of the physiological responses, and particularly their association with implicit memory. While we might often think of memory as something that we can consciously recall and talk about, (termed explicit memory) many of our reactions and responses occur as a result of a different kind of memory that is not conscious (termed implicit memory). Implicit memories are strong, unconscious memories, often laid down very early in life before explicit memory even begins to function. While a kind of memory that we can’t consciously remember might sound odd, it can actually explain a great deal about the responses of traumatised people.

Implicit memory is more like an emotional memory than a memory of something in particular. Such memories are often automatic and faster than ways we might consciously recognise situations. This is particularly relevant in relation to responses to threat, in which survival becomes the priority and therefore the speed of our response is critical. This is why we might sometimes find ourselves startled or suddenly nervous without knowing why. Implicit memories are also very much context-based, meaning that some part of a situation can become a trigger for an implicit response simply because it occurred at the same time as a traumatic event, even if it was unrelated to the event. An example might be that a certain smell or sound that becomes associated with a traumatic event, with implicit memory firing when that smell or sound is present, even in a perfectly safe situation. At times we may not even know it is happening; we simply find ourselves angry, defensive or out of sorts for no apparent reason.

If trauma has occurred in relationship with others, such as primary caregivers, people can develop all sorts of ways of acting and interacting to mitigate what they think is about to happen based on their past experience. Here the body is also deeply involved. Certain postures and movements can develop into patterns that make the body rigid, tense and unable to fully relax. In the case of physical abuse or accidents, particularly if sudden and unexpected, the body might be unable to let go of patterns of tension from interrupted defensive postures or the immobility that the freeze response can engender. Trauma, as feelings, emotions, physical and physiological responses is a phenomenon of the whole body and mind. Bessel van der Kolk expresses this very clearly. He finds again and again that even if a person can’t remember or tells a different story to alleviate their pain, the body really does keep the score.

So how can we work with the body to heal trauma?

embodiment trauma nature healing

Thankfully, understanding trauma as so deeply related to the body gives us many ways to heal. Everyday activities such as physical movement and social contact can be just as healing and relieving for some people as engaging with more formal types of therapy. Singing, dancing and playful movement allow the body to experience the combination of physical feeling and heartfelt enjoyment. Body-oriented meditations and mindfulness practices can be wonderful ways to improve self-regulation, while spending time outdoors and cultivating an appreciation of nature can help people to ground themselves in the present moment. Anything that helps a person to really feel their own vitality and aliveness, in the present moment, can become a support in the recovery from trauma.

Therapies that work directly with the body feelings and sensations can help traumatised people to access implicit patterns while feeling safely held within a therapeutic relationship. These include psychotherapies such as somatic experiencing and bodywork modalities such as biodynamic craniosacral therapy. These therapies include strategies to help people safely discharge held tension or difficult emotions, remaining within the range that they can tolerate without becoming overwhelmed. People can learn to regulate their own bodies and emotions, developing their own sense of safety and agency. Depending on the person, therapies such as these can be either an important complement to more traditional forms of psychology and psychiatry, or can be effective as treatments on their own. As van der Kolk says:

“The challenge is not so much learning to accept the terrible things that have happened but learning how to gain mastery over one’s internal sensations and emotions. Sensing, naming and identifying what is going on inside is the first step to recovery.”

The main principle for trauma recovery is safety: safety in your own body, safety in your own feelings and thoughts, and safety with other people. Put simply, learning to safely feel and listen to your own body can be profoundly healing and transformative.

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